Wednesday, April 8, 2009

Autism discussion must focus on education, early intervention

By Karyl Caplan

As we celebrate National Autism Awareness Month in April, we must recognize the critical role that education plays in the growth and development of people with autism. Although investment in research is still essential to find a cause of and, it is hoped, a cure for this increasingly prevalent disorder, we need to direct the focus - and greater resources - toward educational programs to help people with autism continue to lead full and productive lives.

Autism is a complex neurological condition that typically appears during the first three years of life and affects a person's ability to communicate and interact with others. It is part of a group of disorders known as autism spectrum disorders. According to the federal Centers for Disease Control and Prevention, the prevalence of autism has risen to 1 in 150, affecting about 1.5 million Americans and making it more common than pediatric cancer, diabetes and AIDS combined. Of the approximately 4 million babies born every year, 24,000 of them will eventually be identified as having autism.

Autism can usually be diagnosed by age 3, although new research has advanced the age of diagnosis to as early as 6 months. Currently there are no effective means to prevent autism, no foolproof treatments and no cure. Studies have shown, however - and our experience at ARC's Prime Time For Kids Early Learning Center has borne out - that early intervention has a dramatic impact on reducing the symptoms of autism.

Although parents may have concerns about labeling a toddler as having autism, the earlier the diagnosis is made, the earlier interventions may begin. Intervention - as early as possible up to age 3 - in an appropriate educational setting yields significant improvements for many children with autism by the time they enter kindergarten, often decreasing the need for intensive supports. Effective programs focus on developing communication, social and cognitive skills.

A teaching method called applied behavior analysis (ABA) has been very successful in mitigating behaviors associated with autism and increasing communication, learning and appropriate social behavior. It is based on the premise that appropriate behavior - including speech, academics and life skills - can be taught using scientific principles involving reinforcement.

In particular, an ABA technique known as verbal behavior has proved especially effective in improving communication proficiency. Using this strategy, instructors introduce the child to language through the use of sign language. The child then learns to articulate and use sign language concurrently, and eventually discontinues signing while maintaining articulation skills.

Our instructors have employed this method for the majority of their learners. We also provide training for parents of children with autism so that families may apply these successful techniques at home. In addition to building communication skills, the program trains parents to help their children develop life skills such as playing with siblings, making the right food choices, appropriate behavior in public settings, and other real-life situations outside the classroom.

Although great strides have been made in treating children with autism, the challenges of educating these individuals remains formidable. The Autism Society of America estimates that the lifetime cost of caring for a child with autism ranges from $3.5 million to $5 million, and that this country faces almost $90 billion annually in costs for autism, encompassing research, educational spending, insurance costs, therapeutic services and other expenses.

Much has been written in the mainstream press of a purported link between early immunizations and higher rates of autism. Symptoms of autism are first noted by parents as their child begins having speech delays after age 1. The vaccine for measles, mumps and rubella is initially given to children at 12 to 15 months. Since this is also an age when autism commonly manifests itself, it is not surprising that autism follows immunization in some cases.

Although the debate over the role that vaccines play in causing autism has intensified, researchers have not found a definitive link between the two. As researchers continue to seek answers about possible causes of this complex disorder, we should not overlook the singular importance of education in the life of a child with autism. As the spotlight shines on autism awareness this month, we must renew our focus on providing the highest quality educational programs so that people with autism can continue to make a positive contribution to our community. They deserve no less.

The writer is executive director of ARC of Rockland.


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